Journal article
Onyx embolization for dural arteriovenous fistulas: a multi-institutional study
Journal of neurointerventional surgery, Vol.14(1), pp.57-62
02/25/2021
DOI: 10.1136/neurintsurg-2020-017109
PMID: 33632883
Abstract
BackgroundAlthough the liquid embolic agent, Onyx, is often the preferred embolic treatment for cerebral dural arteriovenous fistulas (DAVFs), there have only been a limited number of single-center studies to evaluate its performance.ObjectiveTo carry out a multicenter study to determine the predictors of complications, obliteration, and functional outcomes associated with primary Onyx embolization of DAVFs.MethodsFrom the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) database, we identified patients who were treated for DAVF with Onyx-only embolization as the primary treatment between 2000 and 2013. Obliteration rate after initial embolization was determined based on the final angiographic run. Factors predictive of complete obliteration, complications, and functional independence were evaluated with multivariate logistic regression models.ResultsA total 146 patients with DAVFs were primarily embolized with Onyx. Mean follow-up was 29 months (range 0–129 months). Complete obliteration was achieved in 80 (55%) patients after initial embolization. Major cerebral complications occurred in six patients (4.1%). At last follow-up, 84% patients were functionally independent. Presence of flow symptoms, age over 65, presence of an occipital artery feeder, and preprocedural home anticoagulation use were predictive of non-obliteration. The transverse-sigmoid sinus junction location was associated with fewer complications, whereas the tentorial location was predictive of poor functional outcomes.ConclusionsIn this multicenter study, we report satisfactory performance of Onyx as a primary DAVF embolic agent. The tentorium remains a more challenging location for DAVF embolization, whereas DAVFs located at the transverse-sigmoid sinus junction are associated with fewer complications.
Details
- Title: Subtitle
- Onyx embolization for dural arteriovenous fistulas: a multi-institutional study
- Creators
- Yangchun Li - Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USAStephanie H Chen - Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USARidhima Guniganti - Department of Neurological Surgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USAAkash P Kansagra - Department of Neurological Surgery, Washington University in St Louis, St Louis, Missouri, USAJay F Piccirillo - Department of Neurological Surgery, Washington University in St Louis, St Louis, Missouri, USAChing-Jen Chen - Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, USAThomas Buell - Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USAJason P Sheehan - Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USADale Ding - Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USAGiuseppe Lanzino - Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USAWaleed Brinjikji - Mayo Clinic Minnesota, Rochester, Minnesota, USALouis J Kim - Department of Neurological Surgery, University of Washington, Seattle, Washington, USAMichael R Levitt - Department of Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, USAIsaac Josh Abecassis - Department of Neurosurgery, University of Washington, Seattle, Washington, USADiederik O Bulters - Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UKAndrew Durnford - Department of Neurosurgery, University of Southampton, Southampton, Hampshire, UKW Christopher Fox - Department of Neurosurgery, Mayo Clinic Hospital Jacksonville, Jacksonville, Florida, USAAdam J Polifka - Department of Neurosurgery, University of Florida, Gainesville, Florida, USABradley A Gross - Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USASamir Sur - Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USADavid J McCarthy - Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USADileep R Yavagal - Department of Neurology and Neurosurgery, University of Miami, Miami, Florida, USAEric C Peterson - Department of Neurological Surgery, University of Miami, Miami, Florida, USAMinako Hayakawa - Division of Neurointerventional Surgery, Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa City, Iowa, USAColin Derdeyn - Department of Radiology and Interventional Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAEdgar A Samaniego - Department of Neurology, Radiology and Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USASepideh Amin-Hanjani - Department of Neurosurgery, University of Illinois, Chicago, Illinois, USAAli Alaraj - Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USAAmanda Kwasnicki - Department of Neurosurgery, University of Illinois Hospital and Health Sciences System, Chicago, Illinois, USAFady T Charbel - Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USAJ Marc C van Dijk - Department of Neurosurgery, Universitair Medisch Centrum Groningen, Groningen, Groningen, NetherlandsAdriaan RE Potgieser - Department of Neurosurgery, University of Groningen, Groningen, Groningen, NetherlandsJunichiro Satomi - Department of Neurosurgery, Tokushima University Hospital, Tokushima, Tokushima, JapanYoshiteru Tada - Department of Neurosurgery, Tokushima University, Tokushima, Tokushima, JapanAdib Abla - Department of Neurosurgery, University of California, San Francisco, California, USARyan Phelps - Department of Neurosurgery, UCSF, San Francisco, California, USARose Du - Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USAPui Man Rosalind Lai - Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USAGregory J Zipfel - Department of Neurological Surgery, Washington University, St Louis, Missouri, USARobert M Starke - Department of Radiology, University of Miami School of Medicine, Miami, Florida, USA
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.14(1), pp.57-62
- DOI
- 10.1136/neurintsurg-2020-017109
- PMID
- 33632883
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health, award: R01NS111119-01A1; name: Miami Clinical and Translational Science Institute, award: UL1TR002736, KL2TR002737
- Language
- English
- Date published
- 02/25/2021
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984070963302771
Metrics
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